1.Single-centre diagnosis, treatment and prognostic analysis of abdominal aortic endograft infection
Xuebin WANG ; Bin LIU ; Zhe ZHANG ; Hongzhi YU ; Zhiwen ZHANG ; Lishan LIAN ; Xiang GAO ; Hai FENG ; Xueming CHEN
International Journal of Surgery 2024;51(11):759-765
Objective:To summarise and analyse the experience in the diagnosis and management of abdominal aortic endograft infection in recent years.Methods:Retrospectively summarised and analysed the general data, clinical presentation, laboratory and imaging findings, causative organisms and treatment choices of 14 patients with abdominal aortic endograft infection treated in Beijing Friendship Hospital, Capital Medical University, from January 2018 to June 2024, and analysed the prognosis of the patients and the risk factors associated with prognosis.Results:Positive bacterial cultures were 10 out of 14 patients. One non-operatively treated patient died of infectious toxic shock. Thirteen surgically treated patients underwent axillary-bifemoral artery bypass, removal of the infected stent, and closure of the aortic stump. Four of the 13 cases had combined aortoenteric fistula, 3 cases underwent one-stage enterocutaneous fistula repair, 1 case only fistula drainage, 3 cases of gastrojejunal anastomosis, all of them underwent gastric or jejunal nutrient tube implantation. Two of the 13 patients had combined the infection foci spread to the renal artery openings. To save the kidney, intraoperative left kidney autologous renal transplantation was performed in 1 case, and autologous saphenous vein reconstruction from celiac trunk artery-left renal artery and superior mesenteric artery-right renal artery was performed in the other case. All 14 patients were retrospectively summarised and followed up in August 2024, with 5 deaths in the early postoperative period (< 3 months), 3 deaths in the mid- to long-term period (≥3 months), and 5 survivors, with a median follow-up time of 2 years (1-5 years) for surviving patients. Among the 13 operated patients, 4 cases were combined with aortoenteric fistula, and 3 cases died in the early postoperative period; 4 cases of abdominal aortic infection foci involving renal artery openings, 2 cases of early postoperative death; 4 cases with pleural effusion, 4 cases died in the early postoperative period; 2 cases of combined creatinine elevation, 2 cases of early postoperative death; 2 cases of postoperative infection of artificial blood vessels.Conclusions:Abdominal aortic endograft infection are aggressive. The risk of early death is increased in patients who are elderly, in poor general condition, with aortoenteric fistula or with pre-existing cardiac, pulmonary, hepatic and renal insufficiency, but surgery based on adequate anti-infective therapy remains an effective means of saving the patient′s life.
2.Dynamic disease manifestations among individuals infected with SARS-CoV-2 Omicron variant.
Peiqin WANG ; Xinwei FENG ; Zhiwen SHI ; Zimao JIANG ; Luping WANG ; Xin GAO ; Hui QI ; Min CHEN ; Jian WANG ; Weifen XIE
Chinese Medical Journal 2023;136(22):2768-2770
Humans
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COVID-19
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SARS-CoV-2
3.Clinical application of G-iliac? iliac branch device in the treatment of common iliac artery aneurysm
Wenrui LI ; Hai FENG ; Zhiwen ZHANG ; Bin LIU ; Hongzhi YU ; Xiang GAO ; Zhe ZHANG ; Xueming CHEN
International Journal of Surgery 2023;50(7):464-468,C2
Objective:To analyze the safety and efficacy of G-iliac? iliac branch device (IBD) in the treatment of common iliac artery aneurysm.Methods:The clinical data of 7 patients with common iliac artery aneurysm who were treated with G-iliac? IBD and internal iliac artery (IIA) preserved were retrospectively analyzed in the Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University from June 2021 to June 2022, and the surgical effects and related complications were analyzed.Results:All 7 patients were male, aged from 57 to 80 years, with an average age of 70.9 years. There were 6 cases of abdominal aortic aneurysm combined with common iliac artery aneurysm and 1 case of simple common iliac artery aneurysm, all of them were successfully applied with G-iliac? IBD to preserve IIA. Cardiogenic shock occurred in 1 patient after the operation. 7 patients were followed up for 3-15 months, with an average of 8 months. During the follow-up period, the iliac artery and IIA stents were all patency, and there was no IBD-related endoleak, stent displacement, buttock claudication, sexual dysfunction, or aortic-related death. The diameter of abdominal aortic aneurysm and common iliac artery aneurysm were stable.Conclusion:For patients with common iliac artery aneurysm, preservation of IIA with G-iliac? IBD is a safe and effective technique with a high technical success rate and IIA patency rate, and has a low complication rate, but the long-term effect still requires more data and longer follow-up data to support.
4.Review of research on anti-gastric cancer mechanism of TCM compounds
Simiao LIU ; Jingri XIE ; Xianjun RAO ; Guangye LIANG ; Zhiwen SUN ; Xi GAO
International Journal of Traditional Chinese Medicine 2023;45(7):916-920
Traditional Chinese Medicine (TCM) shows unique advantages in the field of adjuvant treatment of gastric cancer. The main mechanism of TCM in improving gastric cancer includes regulating cell proliferation and apoptosis, reversing cell resistance, reducing the ability of invasion and metastasis and epithelial-mesenchymal transformation, regulating immune function, inhibiting neovascularization, regulating autophagy exosome, and ferroptosis.
5.Effects of attentional bias training on attention bias, psychological craving and relapse rate in male patients with alcohol dependence
Jing GAO ; Zhuang CAI ; Zhiwen WANG ; Kebing YANG ; Yajuan NIU ; Zhaoxia ZHAO ; Li ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2022;31(2):128-135
Objective:To explore the effect of attentional bias training on the attentional bias, psychological craving and relapse rate of alcohol dependent patients during rehabilitation.Methods:A randomized controlled trial was used to select 90 alcohol-dependent patients and randomly divide them into an intervention group and a control group. The alcohol cue pictures and neutral pictures were imported into E-Prime software at a ratio of 1∶1.The patients in the two groups were trained for eight times with attentional bias and without attentional bias by point delection paradigm. After each training, the software automatically records the response time and correct rate of the cue pictures and neutral pictures, and before intervention(T0), after 4 interventions(T4), and after 8 interventions(T8), the alcohol craving score was assessed by visual analogue scale and the relapse situation was followed up 1 month after the intervention. SPSS 24.0 software was used for statistical analysis.Repeat measure ANOVA, χ2 test and t-test were used to compare the response time, accuracy and psychological craving of the two groups. Results:Repeated measurement analysis of variance showed that there were interaction between group and time in cue-map response time, line chart accuracy and psychological craving score of the two groups ( F=5.218, 6.939, 147.14, all P<0.01). Simple effect analysis showed that there was no significant difference in cue pictures response time, cue pictures accuracy and psychological craving score between the intervention group and the control group at T0(all P>0.05), but there was significant difference at T4 and T8 (all P<0.05), and there was significant difference in neutral pictures reaction only at T8 ( P<0.05). The comparison between two groups showed that the intervention group showed a downward trend in cue pictures response, T4 and T8 were lower than T0, with statistical difference (both P<0.001), while there was no difference in the control group. In the intervention group, the correct rate of cue pictures increased, T4 and T8 were higher than T0, and there were statistical differences (both P<0.001), while there was no difference in the control group( P>0.05). The psychological craving scores of both the intervention group and the control group showed a downward trend, T4 and T8 were lower than T0, there were statistical differences (both P<0.001), but the difference between T4 and T8 in the control group remained unchanged. One month after the end of the intervention, the difference in the rate of relapse between the intervention group and the control group was marginal (11.10%, 26.70%, P=0.059). The total number of days of abstinence in the intervention group was longer than that in the control group ((28.33±4.99)d, (26.47±6.66)d, P=0.010). Conclusion:Attentional bias training can improve the mental craving and attentional bias of alcohol-dependent patients during the rehabilitation period, and the relapse rate decreased one month after the intervention.
6.Inhibition of ginsenoside Rb 1 on the epithelial-mesenchymal transition of renal tubular epithelial cells by regulating TGF-β1/Smad3 signaling pathway
Zhiwen LIU ; Jiangyan XU ; Zhenqiang ZHANG ; Xiaowei ZHANG ; Gai GAO ; Mengmeng WANG ; Hui WANG ; Zhenzhen LI ; Zhishen XIE
China Pharmacy 2022;33(5):535-541
OBJECTIVE To study the effects of ginsenoside Rb 1(G-Rb1)on epithelial-mesenchymal transition (EMT)of renal tubular epithelial cells and its potential mechanism. METHODS The growth factor β1(TGF-β1)10 ng/mL was used to induce EMT of human renal tubular epithelial cells HK- 2. The morphological changes of HK- 2 cells were observed after treated with 10, 20,30 μmol/L G-Rb1 for 48 h. The transcriptional activities of biovector SBE in human embryonic kidney cell HEK 293 were determined after 24 h treatment with 1.0,2.5,5.0,10,20,30 μmol/L G-Rb1. Effects of above concentration of G-Rb 1 on the viability of HK- 2 cells were determined after 24 h of treatment. mRNA expressions of α-smooth muscle actin (α-SMA),collagen Ⅰ (COL-Ⅰ)and fibronectin (FN)in HK- 2 cells were detected after treated with 10,20,30 μmol/L G-Rb1 for 24 h. The expressions of α-SMA,Smad3,p-Smad3,COL-Ⅰ,FN and E-cadherin were detected after treated with 10,20,30 μmol/L G-Rb1 for 24 h. RESULTS G-Rb1 of 10-30 μmol/L significantly inhibited TGF-β1-induced EMT in HK- 2 cells and the increase of transcriptional activities of biovector SBE induced by TGF-β1(P<0.05),but had no effects on relative activities of HK- 2 cells(P>0.05). The protein and mRNA expressions of α-SMA,COL-Ⅰ and FN , the protein expressions of Smad 3 and p-Smad 3 were significantly up-regulated induced by TGF-β1(P<0.05),while the protein expression of E-cadherin was significantly down- regulated(P<0.05);G-Rb1 could effectively reverse aboveprotein or mRNA expressions. CONCLUSIONS G-Rb1 can protect renal tubular epithelial cells from EMT induced byxiezhishen TGF-β1 to a certain extent ,which may be related to inhibiting the activation of TGF-β1/Smad3 signaling pathway.
7. Research progress of mitochondrial dysfunction in sepsis
Yanlong WEI ; Xiaoyu DONG ; Zhiwen SHANG ; Gongpeng ZHANG ; Zhipeng CHENG ; Qin GAO
Chinese Journal of Clinical Pharmacology and Therapeutics 2021;26(11):1292-1299
Sepsis is life-threatening multiple organ failure (MOF) caused by the disorder of body's response to infection. Although it is the main reason of death in intensive care patients, the mechanism of sepsis-induced MOF is still unclear. As an essential organelle of cells, mitochondrial is responsible for many funtions in cells such as energy supply and signal regulation. Recent researches showed that mitochondrial dysfunction may be one of the important reasons of MOF. This review describes the pathophysiological functions of mitochondria and the pathological damage mechanisms of MOF in sepsis, it will provide the therapeutic targets or new ideas for clinical treatment of sepsis.
8. Current status and influencing factors of hearing loss in suspected occupational noise-induced deafness among electric welders in Nantong City
Shiwei YIN ; Chunhua LU ; Ping ZHOU ; Zhiwen ZHOU ; Haiping GAO ; Zeyun YANG
China Occupational Medicine 2019;46(05):604-608
OBJECTIVE: To analyze the current status and influencing factors of hearing loss in the suspected occupational noise-induced deafness(ONID) among welders in Nantong City. METHODS: A total of 3 265 noise-exposed welders who underwent the occupational health examination in Nantong City in 2017 were collected as the study subjects by judgment sampling method. The data of occupational medical examination of these welders was collected. The incidence and influencing factors of suspected ONID were analyzed. RESULTS: A total of 159 cases of suspected ONID were detected and the detection rate was 4.87%. The suspected ONID was mainly mild noise-induced deafness, accounting for 82.39%(131/159). The abnormal rates of 4 000 Hz hearing threshold in the left and right ears of suspected ONID cases were higher than that of 3 000 Hz in the corresponding ears(100.00% vs 93.08%, 98.11% vs 92.45%, P<0.05). The multivariate logistic regression analysis showed that age and length of service during noise exposure were risk factors for suspected ONID(P<0.05). The risks of suspected ONID among welders in general equipment manufacturing industry, metal products industry, other industries, electrical machinery and equipment manufacturing industry, and manufacturing of equipment of railways, ships, aerospace and other transportations were lower than that in computer, communication and other electronic equipment manufacturing industry. The odds ratio(OR) and 95% confidence interval(95%CI) were 0.341(0.155-0.752), 0.264(0.112-0.620), 0.149(0.038-0.582), 0.110(0.035-0.341), 0.418(0.179-0.972), respectively. The risk of suspected ONID among welders in state-owned enterprises was lower than that in private enterprises(OR=0.254, 95%CI 0.116-0.559,P<0.01). CONCLUSION: The age, service length of noise exposure, type of enterprise industry and economy of enterprise are all influencing factors of suspected ONID in electric welding workers in Nantong City.
9.DiagnosticvalueofMSCTcombinedwithultrasonographyinpatientswithacuteappendicitis
Zhiwen JIANG ; Xiaomeng GAO ; Chi ZHENG ; Wenlong ZHANG
Journal of Practical Radiology 2019;35(3):400-402,421
Objective ToexploretheclinicalvalueofMSCTcombinedwithultrasonographyinthediagnosisofacuteappendicitis. Methods 238patientswithsuspiciousappendicitisunderwentMSCTandultrasonographybeforesurgery.Allpatientsweredivided intoappendicitisgroupandnormalappendixgroupaccordingtoCTappearances.TheefficacyofMSCTcombinedwithultrasoundin diagnosingappendicitiswasanalyzedbycomparisonofsurgicalpathologicalfindings.Results Therewere220casesinappendicitis group,whichhad165casesofappendicitisconfirmedbypathology,and55casesofnormalappendix.Therewere18casesinnormal group,2caseswereconfirmedappendicitisbypathology,and16caseswerenormalappendix.Theoveralldiagnosticperformancesof theCTscanwere98.8%ofsensitivity,22.5%ofspecificity,82.5%ofpositivepredictivevalue,88.9%ofnegativepredictivevalue, and76.1%ofaccuracy.TheperformancesofMSCTcombinedwithultrasonographywere90.4%ofsensitivity,93.0%ofspecificity, 96.8%ofpositivepredictivevalue,80.5%ofnegativepredictivevalue,and91.2%ofaccuracy.Thedifferencewasstatisticallysignificant indiagnosisperformancesbeforeandafterMSCTcombinedwithultrasonography (P<0.001).Conclusion MSCTcombinedwith ultrasonographyexaminationcouldimprovethediagnosticaccuracyofappendicitis,andmayreducethenegativerateofappendectomy.
10.Effects of serum cytokines on antipsychotic medication treatment in schizophrenia patients
Guangman ZHANG ; Ying LI ; Wen ZHANG ; Qinghao TONG ; Wanqing YU ; Zhiwen GAO ; Fengxian CHENG ; Xiaohong DAN ; Kun WANG ; Jingjing CHENG ; Huan LIU ; Qin HUANG ; Huabin XU
International Journal of Laboratory Medicine 2017;38(6):735-736
Objective To study the levels of serum cytokines in schizophrenic patients and their changes in antipsychotic medica-tion treatment .Methods The levels of serum cytokines including IL-10 ,IL-6 ,IL-13 ,IL-4 ,IFN ,TNF-α,IL-1a and IL-1RA were de-tected in 34 healthy adults and 53 schizophrenia patients by adopting the flow fluorescence method .Results The serum levels of IL-6 ,IL10 and TNF-αbefore treatment in schizophrenic patients were significantly higher than those in the control group (P<0 .05) . After treatment ,the levels of serum IL-1a ,IL-6 and TNF-α in schizophrenic patients were significantly lower than those before treatment(P<0 .05) .Conclusion Serum IL-6 and TNF-α levels are correlated with the disease condition of schizophrenia .IL-10 plays a role in early anti-inflammation of schizophrenia .

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